Title Page

  • Job Name:

  • Job Number:

  • Job Location:

  • Project Manager:

  • Superintendent Name:

  • Safety Representative:

  • Conducted on

  • Prepared by:

  • Techniques and Operations

Fall Protection:

  • Hazard(s)

  • Competent Person:

Drill Rig(s):

  • Hazard(s)

  • Daily Inspection

Heavy Equipment (Endloaders/Forklifts/Bobcats):

  • Hazard(s)

  • Qualified Operators

Rigging:

  • Hazard(s)

  • Nylon Slings (Remove if stitches are ripped, core shows, cuts, etc.)

Personal Protective Equipment (PPE):

  • Hazard(s)

Hand/Power Tools:

  • Hazard(s)

  • Superintendent's Signature:

  • Safety Representative's Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.